Changing Trend of Neonatal Septicemia and Antibiotic Susceptibility Pattern of Isolates in Nepal

Abstract

Background. Neonatal septicemia is one of the most common leading reasons for neonatal morbidity and mortality in developing countries. Frequent monitoring on pathogens with recent updates and their antimicrobial sensitivity pattern is mandatory for the better treatment. The aim of the study was to determine the bacteriological profile of neonatal septicemia and their antibiotic susceptibility pattern. Methods. This was a cross-sectional study conducted in Outpatient Department (OPD), Neonatal Intensive Care Unit (NICU), and Pediatrics Ward of Chitwan Medical College Teaching Hospital (CMCTH), Bharatpur, Nepal. Blood cultures were performed on all suspected neonates attending to the hospital with a clinical analysis of neonatal septicemia. Isolated organism was identified by the standard microbiological protocol and antibiotic sensitivity testing was done by Kirby-Bauer disk diffusion method. Results. Out of 516 specimens, bacterial growth was obtained in 56 specimens (10.8%). Prevalence of early onset sepsis was higher 35 (62.5%) in neonates compared to late onset sepsis 21 (37.5%). Majority of neonatal septicemia were caused by gram-negative isolates 39 (69.6%). Acinetobacter species 18 (32.1%) was most commonly isolated organism followed by Staphylococcus aureus 11 (19.6%). The predominant isolate in early onset septicemia was Acinetobacter species 18 (32.1%) and Staphylococcus aureus 9 (16%) and in late onset septicemia was Staphylococcus aureus 11 (19.6%) and Acinetobacter species 5 (8.9%). Staphylococcus aureus and coagulase-negative Staphylococci displayed highest susceptibility towards vancomycin, amikacin, teicoplanin, and meropenem. Gram-negative isolates showed susceptibility towards amikacin, piperacillin/tazobactam, meropenem, ofloxacin, and gentamicin. Conclusions. Acinetobacter species and Staphylococcus aureus remain the most predominant organisms responsible for neonatal septicemia in a tertiary care setting and demonstrate a high resistance to the commonly used antibiotics. Above all, since the rate of Acinetobacter species causing sepsis is distressing, inspiring interest to control the excess burden of Acinetobacter species infection is mandatory.

Study of Antibiotic Susceptibility among Bacterial Isolates in Neonatal Intensive Care Unit of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

“…The present study showed EONS to be more common than LONS which accords to studies done by Thapa, et al Pokhrel, et al and Patel, et al 4 , 11 , 16 whereas contrasts to the studies done by Yadav, et al and Shehab, et al where LONS was more common. 15 , 19 This may be because, most of the neonates with EONS in the present study were outborn (76.5%) and horizontal transmission of bacteria might have occurred from the delivery rooms, NICU rooms, during transportation or vertical transmission from mother's genital tract colonized with the pathogens.…”

“…This finding is similar to another study conducted by Thapa et al (10.8%). 11 Lower positivity rate (6.2%) was elicited in a study conducted in India, 12 whereas higher positivity rate was elicited in studies done in Kanti Children's hospital (16.9%), Patan hospital (20.7%), India (46.0%) and Egypt (42.8%). 13 – 16 The variation may be due to the culture techniques, administration of antibiotics before obtaining culture specimen and study designs.…”

Comparative study of antimicrobial prescribing pattern between Nepal and Pakistan

“…In a developing country such as Nepal and Pakistan, where there is excessive use of antibiotics, there is an increased risk of antibiotic resistance to the microbes causing va-rious community and hospital-acquired infection. The high prevalence of antimicrobial resistance was observed against certain common bacterial clinical isolates (Staphylococcus aureus, E. coli) for the commonly used antibiotics like amoxicillin, cotrimoxazole, fluoroquinolones and third-generation cephalosporins in Nepal and Pakistan [8,9]. There must be proper follow of standard guidelines, and the prescriber should have proper knowledge of the biology of microbes.…”

Bacterial profile and drug resistance patterns in neonates admitted with sepsis to a tertiary teaching hospital in Ethiopia

“…and Citrobacter spp. These bacteria are mostly acquired from the hospital environments, health professionals, and medical devices [33,34]. Moreover, as majority of our study participants (84.1%) had early onset neonatal sepsis, the bacterial etiologies identified in our study somehow deviate from expectations [1,3,4].…”